Developmental dysplasia of hip: Difference between revisions
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==Background== | ==Background== | ||
*D/t abnormal relationship of fem head to acetabulum, usu in o/w healthy infants prior to or shortly after birth | |||
*<2% incidence | |||
*4-6X more common in girls | |||
==Diagnosis== | ==Diagnosis== | ||
Early: see asymm soft tissue folds in groin, buttock & thigh, limb may be pulled prox & short | Early: see asymm soft tissue folds in groin, buttock & thigh, limb may be pulled prox & short | ||
Ortolani on ALL young inf in ED, flex hip & knee @ 90 degrees & the thigh is abducted, the lateral aspect of both thighs should touch the table, the dislocated side will be restricted & have "click" as head slips out of acetabulum | Ortolani on ALL young inf in ED, flex hip & knee @ 90 degrees & the thigh is abducted, the lateral aspect of both thighs should touch the table, the dislocated side will be restricted & have "click" as head slips out of acetabulum | ||
*by 6 wk <30% will have + ortolani or bartlow | |||
<3mo: Utz hip | <3mo: Utz hip | ||
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>3mo: AP pelvis with both legs extended in neutral abduction | >3mo: AP pelvis with both legs extended in neutral abduction | ||
*Shenton's line | |||
*Acetabular angle should be <30' | |||
==Treatment== | ==Treatment== | ||
*Refer ALL pts to pediatric orthopedist | |||
*0-6 mo pavlik harness or spica | |||
*Older=orif | |||
[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 06:39, 6 June 2011
Background
- D/t abnormal relationship of fem head to acetabulum, usu in o/w healthy infants prior to or shortly after birth
- <2% incidence
- 4-6X more common in girls
Diagnosis
Early: see asymm soft tissue folds in groin, buttock & thigh, limb may be pulled prox & short
Ortolani on ALL young inf in ED, flex hip & knee @ 90 degrees & the thigh is abducted, the lateral aspect of both thighs should touch the table, the dislocated side will be restricted & have "click" as head slips out of acetabulum
- by 6 wk <30% will have + ortolani or bartlow
<3mo: Utz hip
>3mo: AP pelvis with both legs extended in neutral abduction
- Shenton's line
- Acetabular angle should be <30'
Treatment
- Refer ALL pts to pediatric orthopedist
- 0-6 mo pavlik harness or spica
- Older=orif